Individual
BILLY M ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW, LADC, LPCC
Contact information
Practice address
1501 XERXES AVE N, MINNEAPOLIS, MN 55411-2851
(763) 522-0100
Mailing address
1501 XERXES AVE N, MINNEAPOLIS, MN 55411-2851
(763) 522-0100
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
300215
MN
101YA0400X
Addiction (Substance Use Disorder) Counselor
300215
MN
101YP2500X
Professional Counselor
379
MN
104100000X
Social Worker
Primary
12688
MN
1041C0700X
Clinical Social Worker
Primary
12688
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
347720700
MEDICAL ASSISTANCE
MN
Enumeration date
11/29/2006
Last updated
01/30/2026
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